Free neurovascular toe-(joint)-transfers compared to alternative reconstructive procedures for amputation injuries of two and tripartite fingers with substance loss
Issue title: Selected articles from the 3rd Joint Meeting of The European Society for Clinical Hemorheology and Microcirculation (ESCHM) , The International Society for Clinical Hemorheology (ISCH) and The International Society of Biorheology (ISB), Regensburg, Germany, 28 – 30 September 2023
Guest editors: L. Prantl, A. Krueger-Genge and F. Jung
Affiliations: [a] Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Regensburg, Germany
| [b] Department of Plastic and Reconstructive Surgery, Ingolstadt Hospital, Ingolstadt, Germany
Correspondence:
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Corresponding author: Dr. Andreas Kehrer, MD, PhD, FEBOPRAS, MBA, Department of Plastic-, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. Tel.: +49 (0) 941 944 0; Fax: +49 (0) 941 944 6948; E-mail: [email protected].
Abstract: BACKGROUND:Complex injuries of the hand frequently result in loss of essential functional features. Common reconstructive procedures for soft tissue defects of the thumb or phalanges are locoregional flaps like Moberg-, Foucher-, Cross-Finger- or Littler flaps. Microneurovascular toe (joint-) transfers complete the arsenal of operative reconstructive procedures and allow for most detailed reconstructions. Our experiences with free toe transplants are reported and diversely discussed regarding contending procedures. METHODS:From 2010 until 2019 14 patients who received emergency or elective partial or complete toe transfers were compared with a control group (n = 12) treated with contending reconstructive procedures. Aim of the reconstructions was to cover the defect with well-vascularized, sensate tissue, while preserving length and range of motion in a reliable manner. RESULTS:The Kapandji score showed a significant difference (p- value = 0.04) with a score of 9.8 in comparison to control group (Kapandji index = 8.0). CONCLUSION:In our heterogenic patient collective free toe transplants have proven to achieve comparable functional results for reconstruction of two and tripartite phalanxes as opposed to common local reconstructive procedures.
Keywords: Amputations injuries, toe to hand transfer, free pulp flap, hand reconstruction by toe transfer after amputational injuries, wrap around flap great toe, toe joint transfer
